Hospitals try for full ERs, with efficiency - Business First of Columbus:

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Their solutions include more observation rooms, fast-traco units for less-urgent cases and involving doctors earliefr in theintake effort. All three come with upfront costs, but emergency physicians say they’ll brintg payoffs for hospitals while often reducinf bills for patients and In efforts that started a decade ago or as recentltas February, , and report reducing wait timed by an hour or more, nearly eliminatinfg the phenomenon of patients who leave in frustration after incurring an intake charge, and sending patient satisfaction scores througjh the roof.
Emergency departments have become a prime targef for reformers intent on reducing use of the most expensivr entry intothe health-care system. But emergency doctors say the efficiency programs are meant to help them handle increasing volumes thatthey welcome. “The more patientsa we see, the bettee it is for us,” said Dr. Brucw Jones, emergency department medical directorfor OhioHealth’s . Hospitalws in northeast Ohio are exploring triage systems to refet nonemergenciesto urgent-care centers or other clinics, said Tiffany a spokeswoman for the . Columbus emergency departmentse are trying to avoidthat approach.
A fever that mightf be written off as a cold could instea dbe meningitis, and a sore throar can be a symptom of a life-threateningg abscess, said Jones, who’s reluctant to turn away Reformers often paint a picture of patientx clogging ERs with sniffles and minor cuts. A review of 2006 case by the found, however, that 12 percent of cased were nonurgent, even as the volume of visitd climbed. However, emergency departments statewide are reporting more cases of peoplre showing up because they lost insurance along witha job. “Sometimes these patientd have nowhere else to said Dr. Mark Moseley at Ohio State.
“We’ree open 24/7, and I don’y know of any ambulatory care clinics thatsay that.” Creativre approaches to prevent unneeded inpatient stay s are positive if they cost said Kelly McGivern, CEO of the insurerw trade group. “It can’t be just anothed way to charge the she said. “That’s what we’re looking for: lower-cost alternativeds in more clinicallyappropriate settings.” Doctors Hospital broke its record for emergency department volume in Marchn with an average of 205 patientzs a day. A more typicak pace is 190.
Jonez attributed part of the increase to word of moutb since physicians started seeing patients in the firstt minutes of triagein June. Before, a patient wouldn’t see a doctofr until getting to a bed afte three tosix hours. Now, even if the wait is sometimeethat long, the doctord can order tests or drugs so pain is controlled in the interim and treatment beginxs as soon as a bed opens up. Also, 10 percenft to 15 percent of patient can be discharged straight from the increasing access tothe unit’e 24 beds.
, a Canton-based practice that staffs Doctorxs and emergency rooms in nine addedthree full- and three part-time jobs, including physician assistants and nursr practitioners to free physicians’ The practice started the triagwe physician system a few year ago and is adopting it at all hospitalse where it’s under contract. The practice also is sharingy its methodswith , the practice that staffes OhioHealth’s and Riverside and Dublin Methodist hospitals. At Ohio State’x main hospital, a 20-bed Clinicao Decision Unit that opened in Februargcost $1.
9 million and addedc about 50 jobs, but could result in millions in savingd and added revenue, said Moseley, unit medica l director. Patients in the unit stay for up to 23 The charge is more than the typical emergency room bill but much less than a hospital The new unit also freedf six beds for speedier evaluations by doctorsz in the main emergency similar to the prograjmat Doctors. Mount Carmel has used 23-hourf observation units for about10 years, said Tammy vice president for patient care servicez at St. Ann’s Hospital in Westerville and the system’s efficiency leader. It also keeps adopting protocols to reduce time to diagnosisor treatment, she said.
It’sa important to ensure the process doesn’ft get rushed, leading to missed diagnoses or return visits in a few Weidner added. “The more efficient and appropriatthe care,” she said, “the more cost-effective health care is for